| Comprehensive Family Care | |
|
40 S Kyrene Rd Suite 1 Chandler AZ 85226-4675 | |
| (480) 706-0174 | |
| (480) 706-0117 |
| Full Name | Comprehensive Family Care |
|---|---|
| Speciality | Family Medicine |
| Location | 40 S Kyrene Rd, Chandler, Arizona |
| Authorized Official Name and Position | Vanessa Pettit (OWNER/MANAGER) |
| Authorized Official Contact | 4807060174 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Comprehensive Family Care 40 S Kyrene Rd Suite 1 Chandler AZ 85226-4675 Ph: (480) 706-0174 | Comprehensive Family Care 40 S Kyrene Rd Suite 1 Chandler AZ 85226-4675 Ph: (480) 706-0174 |
| NPI Number | 1750585279 |
|---|---|
| Provider Enumeration Date | 06/11/2007 |
| Last Update Date | 01/20/2021 |
| Medicare PECOS PAC ID | 2163403072 |
|---|---|
| Medicare Enrollment ID | O20040526001496 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750585279 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | AZ3344 (Arizona) | Primary |
| Provider Name | Kenneth Lee Pettit |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1447296298 PECOS PAC ID: 4284616616 Enrollment ID: I20040609000852 |
| Provider Name | Alireza Mazoury |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851637631 PECOS PAC ID: 1355588245 Enrollment ID: I20130514000108 |
| Provider Name | Amy S Berkhout |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609132505 PECOS PAC ID: 4981830114 Enrollment ID: I20131119000082 |
| Provider Name | Karen M Trask |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649679853 PECOS PAC ID: 9133442940 Enrollment ID: I20150102000009 |
| Provider Name | Darcel Randall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598168288 PECOS PAC ID: 6608190764 Enrollment ID: I20150120000801 |
| Provider Name | Jeanne Esther Carver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619395399 PECOS PAC ID: 3476865460 Enrollment ID: I20150706000444 |
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